The decision to seek out therapy can be wrought with fear, ambivalence and shame. You may be struggling with some issue or you may want to improve your own mental state. And while popular culture affirms the merits of wellness, too often mental health is still stigmatized, making the decision to enter therapy even more difficult.

Compounding these concerns, mental health is influenced by a variety of biological, environmental and emotional factors, which means progress toward wellness is a journey. This realization may exacerbate the feelings of doubt about the effectiveness of therapy and impatience with the commitment of time involved. Just remember, even after you take the first step by acknowledging the need for support in therapy, a variety of concerns may still pop up.

This list is intended to validate and address your some common fears of starting therapy and help to normalize the process for you:

1. Social Stigma:

Seeking services from a mental health professional requires an acknowledgement that what you are facing is outside of your current ability to manage. Some express a fear that others may negatively judge you for seeking help for a problem or that they may be labeled as weak or “crazy.”

2. Treatment Fears:

Therapy is a vulnerable experience that requires sharing highly personal and private information with someone who is a stranger to you. The therapeutic relationship is a relationship like any other in that it takes time to establish trust. It is natural to initially fear how you will be perceived by a therapist.

3. Fear of Emotion:

Part of initiating therapy may involve revisiting painful or traumatic experiences. You may be faced with discussing or re-living painful emotions.

4. Doubts That Therapy Can Help:

You may seek therapy in a moment of desperation or despair with little hope that you can feel better or that life can change. You may approach therapy with doubts that a therapist may not understand your experience.

5. Self-Disclosure:

You may feel exposed, anxious or uncomfortable about disclosing distressing personal information to a therapist who is new to you or with whom you have not yet established trust.

6. Social Norms:

The idea of seeking support or seeking support outside of your community may run counter to your cultural or community norms.

7. Self-Esteem:

Acknowledging you need help from another person may feel like an admission that you can’t deal with the problem on your own and can result in feeling inadequate.

Seeking support is a brave effort that requires a commitment to self and an investment in your overall well-being. There are inherent risks involved: you may not connect with the first therapist you find or may struggle revisiting past painful experience. Initially, it may not feel good or be easy. But this initial angst can shift to significant relief later on.

As you explore whether to commit to therapy, seek out a therapist who offers a brief consultation. It will help you determine if it is a good fit, if they specialize in working with people in your community or can relate to your specific life experiences. Help is available for all situations and you should find someone with whom you are comfortable. (Read Finding the Right Therapist: 5 Questions to Ask).Therapy is the place to begin a process of allowing you to get to the life you previously only imagined was possible!

What might be other reasons that can make it difficult to seek support?

I think another reason people often avoid booking an appointment is because of the feeling of “not having enough time.” While it certainly can feel time consuming to commit to a weekly appointment, it’s important to remember that you’re taking steps to better your situation and self care is often the most important thing to make time for! Just like you manage to squeeze in a gym session or a dinner with friends, you can also squeeze in time for a 45 minute appointment if you prioritize it!

I think #3, being fearful of emotions, is a big issue for people. Exploring and giving space for emotions can initially be scary because we tend to not give them the time and space they deserve. I’ve had so many clients tell me they were initially terrified to explore their emotions in therapy but after being in treatment for awhile they report feeling lighter after processing those emotions and letting them go.

I think sometimes financial constraints are a genuine concern for folks. It is important to be an informed consumer and educate yourself about various options in your area, from therapists that take insurance in or out of network, to those that offer sliding scale or low fee therapy, to lower-fee services offered at clinics and analytic institutes, to \ hospital-based outpatient services and community mental health agencies. Telehealth (online therapy) is also on the rise, and while this may not be everybody’s cup of tea, it can certainly cut out commute costs – something to consider if there are real issues with ability to travel to an appt.

Especially here in NYC and other therapy-rich cities the added stress of too many choices can also deter people from beginning therapy. Wanting to pick “the best” therapist or the person who advertises specialization in each area people think is important can lead to confusion and frustration in starting therapy. It is important to keep in mind that starting with one person is not a life sentence. Shopping around and being willing to find the right fit for YOU will be extremely helpful in tackling the above mentioned topics that can be scary to address in therapy. The safer you feel in the room, the easier it will feel to open up about your true self.

I believe that relationship is the key to successful therapy. It’s important to have a therapist to you feel safe with and can connect with. I have found it’s also important to have clear expectations and understandings of the therapeutic process. Often people expect the process to be quick which can lead to disappointment. I encourage people to understand that this is a gentle process and a practice of being in relationship with another so that you can look at your emotional experience and better understand what you’re internal messaging is.

Awesome! Glenn this was a pleasure to read. I really appreciate your delivery on the fears associated with considering to start therapy. I also appreciate that you are making people aware of their fears and that those fears are normal. Starting therapy is not easy and things will often feel worse as you process the raw feelings that may present itself, which is why it is important to have a therapist that understands you, can relate to you, and does not judge you.